Effective treatments for restless legs syndrome can be elusive, and most RLS patients are usually willing to try anything to get relief. Studies have shown that certain cardiovascular exercises and leg stretches help. Here’s how to get started...

Engaging in mild to moderate exercise every day is one of the best and least invasive ways to ease the pain of restless legs syndrome (RLS).

Women who engaged in aerobic and lower-body resistance training three times weekly had fewer RLS symptoms than women who didn’t exercise at all, according to a 2011 study by Brigham Young University in Utah.

“Getting daily exercise and maintaining a consistent level of activity that’s not too strenuous are the best ways to minimize symptoms of restless legs syndrome,” says Mark Buchfuhrer, M.D., an internist and pulmonary specialist at SomnoMedix Sleep Disorders Center in the Los Angeles area and co-author of Restless Legs Syndrome: Coping with your Sleepless Nights (Demos Medical Publishing).

“Women who ran marathons before they were diagnosed with restless legs syndrome are understandably frustrated at having to dramatically lower their level of physical training,” he says. “But it’s really the only way to avoid worsening symptoms.”

But not exercising at all will also increase symptoms, according to 2007 University of Kentucky College of Medicine study.

Exercise decreases the pain of restless legs syndrome in several ways. It triggers a complex biochemical process that increases blood flow to leg muscles, releases feel-good endorphins that reduce stress and promote sleep, and increases dopamine, which reduces pain, according to a 2010 study conducted at University of California, Los Angeles (UCLA).

A bonus: Regular exercise can also help you lose excess weight and belly fat – both associated with restless legs syndrome, according to a 2009 Harvard study. Women with a body mass index (BMI) of 30 or more were 42% more likely to have the condition than women who were of normal weight or underweight (BMI of less than 23), according to the study.

Before starting an exercise program, check with your physician and get your medication for restless legs syndrome under control, advises Michelle Bommarito, an American College of Exercise (ACE)-certified fitness instructor and personal trainer who works with women who have the condition.

“It can take medications a few weeks to a few months to kick in,” she says.

Read on for 10 ways to use exercise to minimize RLS symptoms.

1. Exercise at least three days a week.A combination of moderate aerobic exercise and lower-body resistance training three days a week reduced the severity of RLS symptoms by about 50%, a 2006 study by Pennsylvania State University found.

Such classes usually use large muscles to propel the body into the air, with both feet leaving the ground. Examples include jogging, jumping jacks, hops and kickboxing, Bommarito says.

Also avoid strenuous types of yoga, such as Ashtanga yoga and Vinyasa yoga, she adds.

Same goes for strenuous power walking or hiking, which can trigger symptoms, Dr. Buchfuhrer says.

“If you were a marathon runner, long-distance cyclist or you engaged in high-impact aerobics or strenuous weight training when you were diagnosed, plan to scale back your exercise program for at least a year,” Bommarito says.

Patients with restless legs syndrome who received Swedish massage twice a week for three weeks enjoyed relief from symptoms for two weeks after treatment, according to a 2011 study at Brigham Young University.

9. Try leg stretches.“Stretch your leg muscles when you get up and again at bedtime, focusing on stretches that apply tension to the calf or thigh muscles,” says Dr. Buchfuhrer, who offers these tips:

Stand on tiptoe or hold a half-deep knee bend until fatigued.

Sit on the edge of the bed and firmly rub or massage your calves to give the muscles deeper stimulation.

Stretch your legs to their full length and point your toes.

If these treatments don’t help, take a brief walk around your home, taking long steps and bending your legs to stretch your leg muscles.

Here are five more stretches from Bommarito that can help relieve restless legs syndrome pain in your calves, thighs, hips and ankles.

Calf stretch: Stretch out your arms so your palms are flat against a wall and your elbows nearly straight. Keep your right knee slightly bent and step back a foot or two with your left leg, positioning your heel and foot flat on the floor. Hold the pose for 20-30 seconds. Bend your left knee while still keeping the heel and foot flat on the floor. For a deeper stretch, move your foot back a bit farther. Switch legs and repeat.

Hip stretch: Stand facing a chair, with your back against a wall for support. Raise your left foot up and rest it flat on the chair, with your knee bent. Or try placing your foot on a stair while holding the handrail for balance. Keeping your spine straight, press your pelvis forward gently until you feel a stretch at the top of your right thigh. Your pelvis will move forward only a little. Hold for 20-30 seconds. Switch legs and repeat.

Ankle rotations:Sit on the edge of a chair, resting both feet on the ground. Lift your right foot 3 inches off the ground and point your toes. Leading with your toes, form a circle toward your right, keeping the rest of your leg still. Do 10-15 circles, then switch direction and do 10-15 more circles. Repeat with your left foot.

Seated calf stretch: Try this exercise in bed to help relieve RLS cramping and discomfort that can keep you awake. Sitting in bed, straighten your right leg and flex your right foot toward you, clasping your hands around your toes. Pull your toes toward you and hold for 20-30 seconds. Repeat with the opposite leg. If you can’t reach your toes, wrap a towel around them and pull the ends toward you until you feel a stretch in your calves.

10. Find what works for you.“Experiment with several forms of exercise until you find the routine that works best to control your symptoms,” Dr. Buchfuhrer says. “Some people prefer aerobic activities like walking and gentle cycling, while others get more relief from stretching and gentle yoga.”

He adds, “The best time of day to exercise to relieve RLS symptoms can also vary considerably.”

For example, some people prefer exercising early in the day.

“For others, the beneficial effects of exercise may only last a few hours, so they may also need to exercise in the early evening to help relieve symptoms before bedtime,” Dr. Buchfuhrer says.

What’s Your Restless Legs Syndrome IQ?Restless legs syndrome (RLS) might sound like a simple case of someone feeling on edge. After all, many people shake their legs when they’re antsy, bored or nervous. But there’s more to RLS than restless legs. Find out with this quiz how much you know about this often-misunderstood disorder.

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